“My Name is Tiger”: Navigating the Road to Recovery After Acute Injury
Tiger Woods’ road to recovery is just beginning. For many people who have experienced devastating injuries, the stabilization and mitigation of acute injuries is just the beginning. A car accident like the one that Tiger Woods experienced can have long-standing ramifications, some of which could even be lifelong. Although it’s not possible to speculate on the challenges of his specific recovery, it is possible to speak generally about some of the challenges that can develop from the process of recovering from such a substantial injury. People who have such a devastating accident can experience physical, psychological, and social impacts both in the acute and chronic phases following the injury. A person’s life history and level of social support are also important factors in their journey towards healing. There are a multitude of factors that combine to determine a person’s illness experience, and the meaning they draw from it.
Substantial injuries like the ones suffered by Mr. Woods can trigger feelings of helplessness and mortal danger – the two factors most associated with developing Post Traumatic Stress Disorder (PTSD) symptoms. When a person has experienced trauma in their past, the cumulative effects of the traumas are exponential. This complicates the recovery process and makes hypervigilance and avoidance in the future a more complex problem. In the aftermath of surgery, a person recovering from an accident may struggle to understand and make meaning from what happened. The grieving process for what was, and what would have been, might begin. The person may struggle with pain management. This can be especially difficult when someone has a history of struggling with addiction. They may worry that the emergency use of pain medication to stave off shock may have complicated their sobriety.
A compound fracture is at risk for infection, which can sometimes develop after the acute phase. An orthopedist must rely on external fixators, devices that resemble erector sets, but feel like medieval torture devices, to treat the fracture. These devices require daily “pin” care to prevent the pins from getting infected. This may require a series of surgeries. The femur is the strongest bone in the body. In order to heal, the brain diverts resources, and this is correlated with increased depression. Pain makes sleep difficult, further exasperating the situation. If a person already lives with chronic pain, a severe injury like this is likely to result in more chronic pain. It’s important to utilize mindfulness and neurolinguistic patterning to modulate the neuroplasticity involved in the acquisition of chronic pain. When chronic pain has a traumatic trigger, Eye Movement Desensitization and Reprocessing (EMDR) is a useful tool in reintegrating these memories so that they don’t serve as intensity cues for pain.
Physical rehabilitation is not only about healing the body, but also regaining trust in it again, finding what it is now capable of and what can still be relied upon. In this stage, as Voltaire said, “The great is the enemy of the good.” This involves grieving for what was and exploring what can be. The person may need to relearn to walk and may struggle with activities that used to not even merit a thought. The frustration and anger can feel all-encompassing. It can even affect their relationships with others.
Each human brain is folded into the skull in a unique pattern, that’s more unique than that person’s fingerprint. If two people suffer a head injury to the same place on the skull, it can cause an injury to a different part of the brain for each person. This makes head injuries very unique to each individual. Some head injuries are subtle and can go unnoticed at the time. What further complicates the picture is that both psychological and physical trauma can present with mood swings, anxiety, depression, reduced cognition, memory difficulty, sleep disturbances, and personality changes. Chronic pain and the recovery from a major injury can also affect family functioning.
Family members may worry about their loved one and may see them in the “sick” role. The person who was injured may struggle to redefine their role within the family in both the short and long term. Sometimes the specific characteristics of the illness, the individual, and the family cause an incompatibility that makes mobilizing family resources seem impossible. Minuchin, Covelman, and others defined rigidity, enmeshment, and reactivity as three family dynamics that are correlated with increased difficulty in recovery. Pain makes it difficult for partners to sync their respiration and heart rates, or “mirroring.” This makes it difficult for a couple to stay securely bonded when one person is experiencing breakthrough pain.
When an individual going through the physical rehabilitation process is in the public eye they may feel especially pressured to conform to the narrative of an inspirational figure or provide “inspiration porn.” They may feel that their recovery narrative must conform to someone else’s definition of “tough.” This pressure is always counterproductive. No one knows how they would respond to a devastating injury, until it happens. Anyone in this situation needs space to grieve and to heal. Woods’ legs are not the deciding factor of whether he’ll play golf again. I am certain that if he were to become Disabled that there is a place on the National Paralympic Golf team for him. One of the most difficult things to cope with when recovering from injury is all the information on the internet about what someone can’t do, and far too little about what they can do. Rehabilitation requires possibilities. It’s about redefining what possible, so that no matter what, the essential qualities that made a person them, still shine through.
Matthew CP Purinton, LCSW is a Staff Therapist at our University City Office. He currently sees clients via online therapy. To set up an appointment, you can reach him at mpurinton@councilforrelationships.org or 215-382-6680 ext. 3135.